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Aim: To evaluate the efficacy and safety of glaucoma drainage device Ex-PRESS(®) P-50 for combined cataract surgery and glaucoma., Methods: Patients having cataract and open angle glaucoma or patients with open advanced glaucoma which needed two or more antiglaucoma medications were included. Combined cataract surgery and glaucoma with Ex-PRESS(®) P-50 model placed under scleral flap was performed., Results: Out of 40 eyes of 40 patients (55% male and 45% female) completed the study during one-year follow-up. The mean of age was 76.6±11.02y. The intraocular pressure (IOP) decreased significantly during the 12-month follow-up from 23.5 mm Hg to 16.8 mm Hg (Wilcoxon signed ranks test, P<0.001). A 59.5% of patients did not need any topical treatment, 10.8% of them needed one active principle, 27% needed two active principles, and 2.7% of them needed three active principles for successful IOP control (<21 mm Hg)., Conclusion: Combined surgery of phacoemulsification with ExPRESS(®) P-50 lowers IOP from the preoperative baseline and reduces significantly the number of antiglaucoma active principles for IOP control after the operation.

Purpose. To examine biomechanical parameters of the cornea in myopic eyes and their relationship with the degree of myopia in a western healthy population. Methods. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOP), and corneal compensated IOP (IOPcc) were measured using the ocular response analyzer (ORA) in 312 eyes of 177 Spanish subjects aged between 20 and 56 years. Refraction was expressed as spherical equivalent (SE), which ranged from 0 to -16.50 diopters (D) (mean: -3.88 ± 2.90 D). Subjects were divided into four groups according to their refractive status: group 1 or control group: emmetropia (-0.50 ≤ SE < 0.50); group 2: low myopia (-0.75 ≤ SE < 3.00 D); group 3: moderate myopia (-3.00 ≤ SE ≤ -6.00 D); and group 3: high myopia (SE greater than -6.00 D). We analyzed the relationship between corneal biomechanics measured with ORA and SE. Results. CH in the emmetropia, low myopia, moderate myopia, and high myopia groups was 11.13 ± 0.98, 11.49 ± 1.25, 10.52 ± 1.54, and 10.35 ± 1.33 mmHg, respectively. CH in the highly myopic group was significantly lower than that in the emmetropic group (P = 0.07) and low myopic group (P = 0.035); however, there were no differences with the moderate myopic group (P = 0.872). There were no statistically significant differences regarding IOP among the four groups (P > 0.05); nevertheless, IOPcc was significantly higher in the moderately myopic (15.47 ± 2.47 mmHg) and highly myopic (16.14 ± 2.59 mmHg) groups than in the emmetropia (15.15 ± 2.06 mmHg) and low myopia groups (14.53 ± 2.37 mmHg). No correlation between age and the measured parameters was found. CH and IOPcc were weakly but significantly correlated with SE (r = 0.171, P = 0.002 and r = -0.131, P = 0.021, resp.). Conclusions. Present study showed only a very weak, but significant, correlation between CH and refractive error, with CH being lower in both moderately and highly myopic eyes than that in the emmetropic and low myopic eyes. These changes in biomechanical properties of the cornea may have an impact on IOP measurement, increasing the risk of glaucoma.

Purpose: To investigate the effects of Fuchs' corneal dystrophy (FCD) on corneal biomechanical properties and the results of IOP readings in relation to changes in corneal hysteresis (CH) and central corneal thickness (CCT)., Methods: Corneal biomechanical properties, including CH, corneal resistance factor (CRF), and CCT, were measured with the ocular response analyzer (ORA) in 11 eyes of 11 patients with clinically confirmed FCD and 12 eyes of 12 healthy subjects. The ORA was also used to determine the values of intraocular pressure (IOP(g)) and corneal compensated IOP (IOP(cc)). Goldmann applanation tonometry (GAT) was also measured., Results: CH measured 10.3 +/- 1.6 mm Hg (range, 8.7-13.8) in normal eyes and 6.9 +/- 1.8 mm Hg (range, 4.6-11.7) in FCD eyes (P = 0.001). CRF in the normal and FCD eyes was 10.5 +/- 1.5 mm Hg (range, 8.5-13.3) and 8.1 +/- 1.9 (range, 4.5-11.2), respectively (P = 0.005). CCT was higher in FCD eyes (606 +/- 20 microm; range, 578-635) than in normal eyes (538.4 +/- 24.9 microm; range, 495-575; P = 0.0001). IOP(g) was 16.2 +/- 2.2 mm Hg (range, 13.5-18.7) in control eyes compared with 17.6 +/- 2.7 mm Hg (range, 12.8-18.6) in FCD eyes (P = 0.201). However, IOP(cc) in the FCD group (21.8 +/- 4.6 mm Hg; range, 12.8-29.0) was higher than in the control group (16.5 +/- 3.4 mm Hg; range, 11.9-23.9; P = 0.006). GAT in the normal and FCD eyes was 16.7 +/- 2.1 mm Hg (range, 12.8-18.6) and 16.9 +/- 2.3 mm Hg (range, 13.1-19.0), respectively (P = 0.205)., Conclusions: FCD led to a change of corneal biomechanical properties. CH and CRF were significantly lower in FCD eyes than in normal eyes. IOP(cc) was significantly higher in FCD eyes than in control eyes. These values may be useful in addition to CCT when assessing corneal rigidity. Thus, FCD may cause an underestimation error in IOP measurement.